How much does home care cost? And how families make it work

When a family calls us for the first time, the question usually comes within the first minute: "How much is it?" It is the right question to ask. Care for a parent or spouse is one of the biggest expenses a family will take on, and most people have never had to price it before.

The good news is that home care is more flexible, and often more affordable, than most families expect. You pay only for the hours your loved one needs, there is no room fee, and there are more ways to pay for it than most people know. That matters, because AARP's surveys keep finding that about three out of four adults 50 and older want to stay in their own homes for as long as possible: 77 percent in 2021 and 75 percent in 2024. This post walks through what home care costs, how it compares to a facility, and the ways families we work with make it fit their budget.

How home care is priced

Most home care agencies charge by the hour. Rates vary by state, by town and by the level of care your loved one needs. The CareScout Cost of Care Survey publishes median rates for every state each year, and it is a good place to get a feel for the numbers where you live.

Because you pay by the hour, your monthly cost depends on the schedule. Here is how the most common schedules work:

• 4 hours a day, 5 days a week: the most affordable way to start. This covers morning help with bathing, dressing, breakfast and medication reminders.
• Full-time days: a caregiver for most of the waking day, for someone who should not be alone during the day but sleeps safely through the night.
• 8 hours a day, 7 days a week: coverage through the busiest part of the day, every day of the week.
• Live-in care: one caregiver lives in the home and is billed at a daily rate rather than by the hour, which usually makes it the most affordable way to have someone in the home around the clock. We offer live-in care in New Jersey and Pennsylvania.
• Round-the-clock awake care: caregivers work in shifts so someone is awake and alert all night. Because every hour is billed, this is the highest cost option. Most families only need this level of care for a period of time, and we will tell you honestly whether your loved one needs 24-hour care or whether live-in care will do.

Every one of those hours is one-on-one. The caregiver in the home has one job, and that is your mom or dad.

How that compares to assisted living

Families often compare home care to the base rate an assisted living facility quotes on the tour. That comparison leaves out most of the bill.

The base rate covers the room and basic services. Care is usually priced on top of it. AARP warns that most residents pay far more than the listed price because of tiered care levels, medication fees and charges for personal laundry, transportation to appointments and even meals brought to the room. Care levels usually run from Level 1, for minimal support, to Level 4, and medication management often costs more as the number of prescriptions grows. Every step up in care level raises the monthly bill before any extras are counted.

And the price only goes one direction. As needs increase, the facility reassesses and moves your loved one to a higher tier. If those needs go beyond what the facility can handle, the next stop is often a nursing home, which costs more than assisted living and more than most home care schedules.

Here is the part that should weigh on every family's decision. There is no federal staffing standard for assisted living: states set the rules, and most require only enough staff to meet residents' needs. A 2024 study of Ohio assisted living communities found an average of one aide for about every 14 residents during the day, and one for about every 23 overnight. So when you compare monthly costs, compare what that money buys. With home care, every hour you pay for is one caregiver with one person. In a facility, your loved one shares the aide on duty with everyone else on the floor.

At home, there is no rent to pay on top of care. Most older adults already own their homes: AARP's 2021 survey found that nearly 80 percent of adults 50 and older do, and 51 percent have no mortgage. The house your parent already lives in can be the setting for their care, and as we explain below, it can also help pay for it. Our guide to home care versus assisted living goes further into the decision.

Ways families pay for home care

Very few families pay for care from a single source. Most combine two or three of the options below. Talk with your financial advisor, accountant or elder law attorney about which ones fit your situation.

Long-term care insurance

If your loved one bought a long-term care policy, check it first. Most policies cover care at home, not only in a facility. Policies usually have a waiting period, called an elimination period, before benefits start, and a daily or monthly limit. Our office files long-term care insurance claims for clients every month, and we can help you read the policy and get the claim started.

VA Aid and Attendance

Wartime veterans and their surviving spouses who need help with daily activities may qualify for the VA pension with Aid and Attendance. The benefit is paid monthly, the VA updates the rates every year, and it can cover a meaningful share of the cost of care. The amount a family receives depends on income, assets and unreimbursed medical costs, including home care. The application takes time, so start early. Our guide to home care for veterans explains how to apply.

Home equity

For many families, the home itself is the largest asset. A reverse mortgage or a home equity line of credit can turn some of that value into monthly income for care while your loved one stays in the house. These products have costs and rules that need a careful look, so review them with a financial advisor before deciding.

Life insurance

Some life insurance policies allow the owner to draw part of the death benefit early when the insured person has a chronic illness, and some policies can be converted or sold to fund care. Call the insurance company and ask what options the policy has.

The medical expense tax deduction

Home care can count as a deductible medical expense when a licensed health care practitioner certifies that the person receiving care is chronically ill, meaning they need substantial help with at least two daily activities such as bathing or dressing for at least 90 days, or need substantial supervision because of a severe cognitive impairment such as dementia, and the care follows a plan of care from a licensed health care practitioner. If you itemize, unreimbursed medical costs above 7.5 percent of your adjusted gross income can be deducted. Because our care plans are written and overseen by registered nurses, families have the documentation their accountant will ask for.

Sharing the cost as a family

Siblings often split the monthly cost, or one family member covers certain days while paid caregivers cover the rest. A daughter who visits every Sunday might mean you need care six days a week instead of seven. Every shift a family member can reliably cover is a shift you do not pay for.

One thing to know up front: Medicare does not pay for ongoing personal care at home. It covers short stretches of skilled home health after an illness or hospital stay, but not daily help with bathing, dressing, meals and supervision. Planning around that early saves families from surprises later.

Building a schedule that fits your budget

The most affordable care plan is the one built around the hours your loved one actually needs. When we meet a new family, a registered nurse assesses your loved one at home and looks at when the hard parts of the day happen. For some people that is the morning shower and getting dressed. For others it is evenings, when confusion gets worse, or nights, when the risk of a fall on the way to the bathroom is highest.

From there we build a schedule around those times. Many families start with a few hours a day and add more as needs change. Because there is no lease and no level-of-care contract, the plan can grow or shrink with your loved one, and you are never paying for care you do not use.

Filling the gaps with our 24/7 virtual caregiver

Many families worry most about the hours when no one is there. That worry is often what pushes them toward a facility, or toward paying for round-the-clock care before their loved one needs it.

Our 24/7 virtual caregiver, Always On Virtual Care, gives families another option, and seven of our offices offer it. Discreet technology in the home keeps watch day and night, with no cameras, and if something seems wrong, such as a fall or a call for help, our team is alerted so we can respond. It works alongside your in-person caregivers and covers the hours between visits.

For many families, this is what makes the budget work. Instead of paying for a caregiver every hour of the day, you can schedule in-person care for the times your loved one needs hands-on help and let the virtual caregiver cover the rest. Ask us whether it is a good fit for your loved one.

Let's talk numbers

If you are asking "how much is it," you deserve a straight answer for your family's situation, not a brochure. Call us or request care, and we will talk through your loved one's needs, give you real pricing, and help you look at every way to pay for it, so your mom or dad can stay where they want to be: at home.